Recovery From Anorexia Nervosa: Why Is My Treatment Not Working?

Eating disorder recovery is hard to achieve, and many times people will hit a roadblock and become frustrated with treatment.

Have you ever wondered why some people recover from anorexia relatively quickly while others seem to struggle for years? Researchers are looking to answer this question as well.

Looking for Answers

Unfortunately, there will never be one treatment that will work for all eating disorder patients, but some types of treatment do work better than others. Identifying what treatment approaches work best for patients is crucial to improving chances of recovery.

Researchers have begun trying to identify which factors are associated with recovery and which are associated with increased illness duration. Stephanie Zerwas and her colleagues recently published a study in the Journal of Psychiatric Research which looked into factors that could possibly determine a patient’s chances of eating disorder recovery.

The Research

In the study, Zerwas asked 680 anorexic women from nine different sites across North America and Europe to fill out questionnaires and complete structured interviews on eating disorder history, behaviors, personality and temperament, and comorbid disorders. In the study, the researchers defined recovery as being symptom-free for 12 months or more.

Vomiting and High Levels of Anxiety

What Zerwas and her team found was that the presence of self-induced vomiting was strongly associated with a lower likelihood of recovery. Although it is not clear why purging decreases a patients chance of recovery, researchers hypothesize that it could be “related to higher levels of psychological disturbance,” which can interfere with treatment.

Additionally, anxiety was associated with a lower likelihood of recovery. The higher the levels of anxiety, the more prone a person was to resort to restricting, purging and over-exercising in order to remove the anxiety. Therefore, many patients fell into a vicious cycle of negative reinforcement that interfered with recovery.

Furthermore, another factor that makes anxiety damaging for recovery is the fact that anxiety disorders tend to run in families with eating disorder individuals. Anxiety disorders can occur prior to the onset of anorexia nervosa, which suggests that anxiety might increase the risk of developing an eating disorder and subsequently decrease chances of recovery.

Impulsiveness and Higher Chances of Recovery

However, it’s not all bad news for eating disorder patients. Researchers found that impulsiveness was associated with a higher likelihood of recovery. Zerwas explains that although impulsiveness was found to be present at the onset of anorexia, as time went by impulsive behaviors waned in patients.

Although previous studies have found impulsiveness to be associated with negative outcomes, Zerwas et al. have brought to light new findings that could lead to new treatments and ideas. Moreover, what has been uncovered so far will be help develop better treatment options for patients who struggle with recovery.


Eating Disorder Self Test. Take the EAT-26 self test to see if you might have eating disorder symptoms that might require professional evaluation. All answers are confidential.

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